described with the help of photographs two cases of osteoma of the middle ear occurring in a brother (age 10), both ears, and sister (age 6) left ear. The two older children in this family do not appear to have this condition and there is no family history of deafness. X-rays of the boy's mastoids do not^demonstrate these small tumours and both are reasonably well pneumatized. Each child had previously undergone tonsillectomy and adenoidectomy for indications which included exudative otitis media. This had recurred later and was not relieved permanently by suction myringotomy.In the boys case exploration by the Rosen approach revealed on each side a smooth broad-based osteoma arising in the region of the pyramid. The tumour had extended forward to become adherent to the incudostapedial joint which it had immobilized. As much as possible of the tumour was drilled away and the ossicular chain mobilized. The drums now appear normal and the hearing is audiometrically normal.In the girl's case an excess of clear mucus was the only abnormality visible in the right ear. In the left ear a tumour similar to the brother's but slightly smaller was found and drilled away. The drum and hearing are now normal.The aetiology of this condition is obscure. Exostoses outside the drum have been attributed to swimming; but the children although they visited * A paper read at a

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Pilar sheath acanthoma is a rare, benign follicular hamartoma that frequently presents as an asymptomatic, flesh-colored papule with a central opening. First described in 1978 by Mehregan and Brownstein, these lesions generally appear on the upper lip of elderly patients. We present an interesting case of a pilar sheath acanthoma presenting on the earlobe in a middle-aged male. To the best of our knowledge, this is the first reported case of a pilar sheath acanthoma found in such a unique location.

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